| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68.69 | $130.77 | $130.77 | |
Medica
| Facility | $97.10 | $147.07 | $254.28 | |
Midlands
| Facility | $101.90 | $167.80 | $302.58 | |
Sanford Health Plan
| Professional | $115.48 | $177.73 | $250.94 |